Method of and apparatus for effecting medicinal treatment



March 22, 1938. H. a. JOHNSON 2,112,160

METHOD OF AND AFPARATUS FOR EFFECTING MEDICINAL TREATMENT Filed April 4,1955 2 Sheets-Sheet l Harold G. Johnaon,

H. G. JOHNSON March 22, 1938.

METHOD OF AND APPAR'FLTUS FOR EFFECTING MEDICINAL TREATMENT Filed April4, 1933 2 Sheets-Sheet 2 FIG. 11.

Harold 6.. Johnson,

Patented Mar. 22, 1938 OFIQ METHOD OF AND APPARATUS FOR EFFECT- IN GMEDICINAL TREATMENT Harold G. Johnson, Yonkers, N. Y., assignor toKenneth Fredericks, Seattle, Wash.

Application April 4, 1933, Serial No. 664,413

8 Claims.

The present invention relates to a method of and apparatus formedicinally treating selected portions of animal bodies, and moreparticularly to the art of forming medicinal compounds and applying themwithin natural cavities of the hureaching into the minute folds andrecesses characterizing skin and membraneous tissue and effectuallytreating such remote areas. Some branches of investigation have resultedin the development of a technique employing the tendency of gases toexpand to drive or carry a medicament to the desired point ofapplication, thereby accomplishing, in some instances, results superiorto those which would be obtainable were it possible to have a purelyliquid antiseptic with zero surface tension.

; Objects of the present invention are to provide a method of andapparatus for effecting medicinal treatment.

Another object of the invention is to provide-a method of and-apparatusfor introducing medicinal substances, of a nature that they will reactin a predetermined manner upon contact each with the other, into acavity whereby their intermingling may be eificiently controlled.

Another object of the invention is to provide a method of and apparatusfor conveniently handling two or more medicinal substances adapted to bemixed prior to or upon their application toinsure their being broughttogether in the proper proportions.

Another object of the invention is to provide a vaginal syringe whichwill be simple and durable in construction, andconvenient and eff cientin operation for the purposes set forth.

The full nature of the invention, it is believed, will be apparent fromthe following detailed dow, scription of preferred and optionalembodiments of the invention, read in conjunction with the accompanyingdrawings, forming a part thereof, in which,

Fig; 1 is an elevation of a syringe constructed in accordance with oneembodiment of the present invention, showing the cylinders andpassagcsof the characteristic duplex arrangement, and the mixing chamberloaded, and preparatory to the downward discharging movement of thepistons;

Fig. 2 is a corresponding View showing the position of the pistons whenthe reservoir cylinders have been completely emptied;

Fig. 3 is a side elevation showing the mixing chamber sealed and themanner in which the syringe may be folded when not in use;

Fig. 4 is a section taken on the line 4-4 of Fig. 1, showing theconstruction of the reservoir or body portion of the syringe;

Fig. 5 is a View corresponding to Fig. 1, and illustrates the method offilling the reservoir cylinders with different medicaments;

Fig. 6 is a detail in perspective of the piston rod yoke for insuringthe discharge of the medicaments from the cylinders in equal amountswhen the pistons are pressed downwardly;

Fig. 7 is a detail view, partly in section, showing the structure of onetype of mixing chamber nozzle which may be employed; 7

Fig. 8 is a View corresponding to Fig. 7, showing another type of mixingchamber nozzle;

Fig. 9 is an end elevation of a mixing chamber nozzle, showing a singleoutlet hole;

Fig. 10 is a view corresponding to Fig. 9, showing the arrangement of aplurality of outlet holes in parallel alinement with the dividing wallof the bi-passage Y-tube;

Fig. 11 is a detailed View of a flexible, imperforate cap for sealingthe outlet of the mixing chamber nozzle, as shown in Fig. 3; and

Fig. 12 is a view in elevation of a single-passage V-tube having anon-variable mixing chamber, which may be substituted for the outletstructures shown in the remaining views, if desired, for certaintreatments.

Referring to the drawings, wherein the same parts are indicated byidentical reference numerals in the several views, Fig. 1 shows avaginal syringe having a body or reservoir portion, generally denoted bythe numeral 2!, con- 7 sisting preferably of two alined glass cylinders22 and 23 of equal length. The reservoircylinders 22 and 23 are rigidlyheld in parallel relation by an application of celluloid or any suitablecementitious material 25 and reinforced, preferably at three equalpoints, bywire strands 26 applied tightly thereto and cushioned from theglass on bands of rubber 21. In assembling the body portion 2!, care istaken toinsure that the ends of the cylinders are even, for reasons tobe made clear hereinafter. At the lower extremity each of the reservoircylinders 22 and 23 is funnelshaped and flared, as shown most clearly at28 in Fig. 2, in order to facilitate the making fast thereon of tubingto be later described.

Slidable within the cylinders 22 and 23 are piston rods 36 and 3|,respectively, of glass or other suitable material. The upper end of eachcylinder is closed by a rubber stopper 32 which is axially apertured toform a bushing for the piston rod, and is fitted tightly in the cylinderagainst dislodgment when the piston rods are drawn outwardly withrespect to the cylinders,

as when filling them with medicaments. To provide a pumping means forfilling the cylinders 22 and 23 and for discharging the medicamentstherefrom, pistons 34 are provided fast between annular flanges 36 and31 on the lower ends of the piston rods. A small quantity of glycerineor other inert non-volatile lubricant 39 is preferably maintained in thecylinders above the pistons 34 to insure a perfect seal and preventtheir oxidation and sticking. As shown in Figs. 1 and 3, the flanges 36space the pistons from the stoppers 32 when the piston rods 36 and 3|are withdrawn, to provide room for the glycerine 39. When the pistonrods are pressed downwardly the glycerine trickles down the inner wallsof the cylinders and thereby constantly lubricates the paths of thepistons 34. The supply of glycerine may be renewed by means of amedicine dropper applied at the aperture of the stopper 32, the fit ofthe piston rods in the bushings being sumciently loose to afford anaperture for admitting the glycerine when the piston rods are pressedagainst the surrounding rubber.

Preferably, the cylinders 22 and 23 contain a number of doses orapplications. In the present embodiment each of the cylinders indicatesa capacity of approximately seven and one-half cubic centimeters, or atotal syringe reservoir capacity of fifteen cubic centimeters. As shown,the cylinders are graduated, by etching or in any other suitable manner,in thirds for dosage, although obviously the capacity of the cylinders,dosage and the nature of the calibrations 4| may be of any value to suitthe indicated treatment. Referring to Fig. 2, the piston rods 36 and 3|may also be calibrated, as at 42, to permit control of the quantity ofthe medicaments applied from the two cylinders, this feature being ofmarked convenience, in some instances, as when the vaginal syringe isbeing used in self treatment by the operator since with the cylinderseven partially loaded, the piston rods extend nearer to a normal line ofvision than the reservoir cylinders. However, in some instances, even inthe case of self-treatment, satisfactory results are obtainable byreferring to either the markings on the cyinders or those on the pistonrods.

The piston rods 36 and 3| are each provided at the upper end, withspaced annular flanges 43 and 44. The lower flange 44 is preferablyaccurately spaced from the lower rod flanges 36 and 31 so that when itrests upon the stopper 32 the piston 34 is in its lowermost position toinsure expulsion of the last full dose from the reservoir. It will thusbe apparent that when the flanges 43-43 of adjacent piston rods areadvanced in alinement the cylinders are emptied at equal rates andtherefore where the cylinders are of equal dimensions as the preferredshowing indicates, equal volumes of the substances will be expelledtherefrom.

In order to insure that the method may be practiced and the apparatusconveniently and efficiently operated by a lay person or any otherwithout the necessity of practice, a holder or piston yoke 46, Fig. 6,is provided. This holder consists preferably of a single piece of woodor molded material with two parallel notches 41 and 48 formed in theforward face 49 thereof. The notches 4'! and 48 are spaced to receivethe piston rods, fitting thereon between the flanges 43 and 44, and holdthem true in vertical position, as shown in Figs. 1, 2 and 3. The bottom49 of the yoke 46 is preferably flat and rests on the flanges 44, actingas a leveler for them. The upper edges of the holder 46 are beveled asat for easy engagement by the fingers of the operator in pushing thepistons downwardly. When the yoke 46 is pressed down to inject a dose ofthe substances in the cylinders the pistons are advanced in unison withthe flanges 44 and piston heads 34 in alinement, thus insuring that theingredients will be brought together in equal quantities. It is obviousthat this function of unitary control of the rates of expulsion by theyoke 46 may be exercised when the cylinders 22 and 23 vary in diameter,and with limitations, also where they are of different length, sincesuch may be the construction of the syringe reservoir if dictated by thenature of the desired treatment. In lieu of the notches 41 and 46,vertical holes may be formed in the yoke 46 for receiving the upperextremities of piston rods, should it be desired to eliminate the upperterminal flanges 43-43. However, since the upper flanges 43 are ofassistance in withdrawing the piston rods as when filling the reservoircylinders, the construction shown is thought to be preferable. The yoke46 is readily detachable by slipping the rods out of the notches 41 and48, as when filling the cylinders in a manner to be made clear below.

The present syringe includes as an important element an adaptor ordelivery tube 55, designed to extend the length of the vagina withoutrequiring insertion of the syringe body into the orifice thereof, and todeposit in the vicinity of the cervix, or at any outward point, thesubstances from the reservoir cylinders. As shown in Fig. 1, the tube 55is connected with the lower flared ends of the reservoir cylinders bytwo sections of preferably non-kinkable rubber tubing 5656, which arepreferably detachably mounted on the cylinders 22 and 23. The tubing 56is of relatively heavy stock and its interior diameter is such as topermit it to have a very snug fit on the cylinder-end to withstand theexpulsion pressure of the medicaments to pass therethrough; or, suitableclamps of a detachable character may be used to hold the rubber on thecylinder outlets. The tubing 56 which may be of any desired length,constitutes a flexible or hinged connector for the delivery tube 55 andthe syringe body. Since it is non-kinkable, the same easy operation ofthe syringe is permitted regardless of the relative positions of thetube and the syringe body. The syringe is thereby caused to be admirablyadapted for self-treatment by the operator in sitting, standing orreclining position. The provision of the flexible tubing 56 greatlyconveniences the accommodation of the syringe when not in use, since thelatter may be easily doubled up and the required length of storage spacereduced by one half. This feature particularly adapts the syringe to bestored in the conventional medicine cabinet or physicians instrumentcase. Furthermore, the ability to fold the syringe renders it possibleto put up the device in a carton of handy size for merchandising aid. Asshown in Fig. 3, a rubber band or other holder 58 may be used to retainthe apparatus in folded position, upon removing which the flexible tubeunbends to permit the delivery tube55 to assume its extended operativeposition.

In the preferred embodiment illustrated, Fig. 1, the delivery tube 55 isof Y-formation, being bifurcated at the top to form branches BI and 62which are connected by the tubes t5ii to the cylinders 22 and 23respectively. The shank of the tube 55 has two parallel" passages 63 and64 separated by a common wall 65 extending to the lower end or mouth ofthe delivery tube. This construction insures that substances moved fromthe cylinders are maintained apart during .their traversing of thepassages 63 and 64. A

collar 68 may be provided on the extremity of each of the branches 6iand 62 for preventing the tubing 55 from slipping therefrom, and thetubing 56 is preferablysecured permanently to the branches of the Y-tubeby any suitable means, such as a wire 69. At its lower extremity thetube 55 is preferably bulged outwardly, as shown at! l, to assist inretaining thereon against accidental displacement a variable mixingchamber 12 to be described hereinafter.

The mixing chamber 12, which is also in the nature of a nozzle, is madepreferably of rubber,

although it may be of any other non-porous material not readilyattackedby chemicals usually used in medicine. One end of the nozzle 72is apertured to admit the tube 55 and provided with a collar 13 adaptedto closely engage the periphery of the tube 55 to prevent accidentalshifting of the mixing chamber therealong. The mixing chamber i2 isattached by inserting the extremity of the tube 55 in the collar #3 andsliding the mixing chamber therealong to cause the collar 13 to rideover and look behind the bulge-H thus enclosing the ends of the passages53. and 64 within the mixing chamber. The lower end 'of the mixingchamberlZ, in one embodiment of the invention,,is provided centrallywith a relatively small outlet hole 14, Figs. 1, 7 to 9, through whichthe substances are extruded from the syringe.

designed to emit equal quantities of the substances from the passages 63and 64.

i let hole M is used, and provides for their limited combiningregardless of whether or not the substances are mixed in the nozzle '12.V

When it is desired that the substances be not mixed until after theirdischarge from the syringe, the mixing chamber 52 is moved up the tube55 until the lower end of the tube abuts the end of the mixing chamber,as shown in dotted lines in Fig. 1. Such a method 'of application isespecially adapted where the mixing is to result from bodily heat ormuscular activity of the subject, and therefore necessarily delayedbeyond the time of injection. w

Where the nature of theindicated'treatment calls for a slight degree ofmixing'of the'sub stances before their expulsion from the mixingchamber, the latter may be moved farther down the tube 55 approximatelyto the position shown in full lines in Fig. 1. Where the treatmentrequires a thorough mixing of the substances before discharge, as whenan immediate activity is' sought betweenthe substances, the mixingchamber 12 may be moved to the lowermost-posh This hoIe being centrallylocated, is

tionishown in dotted lines in'Fig. '1, wherein the full extent of theinterior of the chamber i2 is available for mixing and the nozzle isheld on the delivery tube 55 by the collar l3 engaging the bulge H.

The mixing chamber 12 is also capable of use as a combined mixing andreservoir chamber. If desired, a third substance may be brought intocontact with the substances from the cylinders by placing it in themixing chamber before the extrusion step occurs. Such an application isshown in Fig. 1, wherein it will appear that a powdered deposit is onthe interior wall of the mixing chamber near as indicated at 78. Themixing chamber may thus be used to present for mixing immediately beforeapplication any additional substance, such as a liquid, colloid, powderor tablet, intended to provide an additional medicament, catalyzer orother agent for the injection. Mixing of said additional material may,of course, be controlled as the materials from the cylinders, byselecting and varying the position of the mixing chamber 12.

The apparatus described is therefore capable of use in applying,orificially, for natural cavities such as the vagina, compounds preparedin several ways. For instance, materials from both cylinders, bothcylinders and the mixing chamber, or either cylinder and the mixingchamber may be compounded before or upon injection, with or withoutprevious contact each with the other.

An imperforate cap 19, Figs. 3 and 11, of rubber or other suitablematerial is provided for placing over the discharge end of the mixingchamber for the purpose of sealing the contents against drying,oxidation or contamination from the atmosphere, or any deterioration dueto being-exposed. The apparatus is thereby adapted to be used atintervals of time without emptying, and therefore convenient for use incases where it is filled with several doses put up personally by thephysician and intended to be returned for refilling after the elapse ofseveral days time.

Fig. 8 discloses a modified form of mixing chamber 8!, adapted to beused in lieu of the chamber 12, wherein the lower or discharge end ofthe chamber is enlarged over the barrel portion to provide greater roomfor mixing.

Fig. 12 is illustrative of a modified form of the invention consistingof a delivery tube 82 having a single passage 83, communicating with twobranches 8% and 86 and adapted to be connected by the rubber tubing 56to the cylinders. On its opposite end, and in direct communication withthe passage 82, is an integral mixing chamber 3?. This structure iscapable, in combination with the cylinders 22 and 23 and the flexibleconnection 56 preferably, of satisfactory use in lieu of the double orbi-passage tube 55 and variable mixing chamber 12 where the natures ofthe substances compounded permit their mixing shortly beforeapplication, and'it is desired that they be extremely well mixed beforeextrusion.

The operation of the device'is as follows: The chambers or cylinders 22and 23 are preferably filledseparately by removing the tubing 56 andconnecting a short length of tubing to the cylinder first to be filled.The piston yoke 36 having been disconnected, the piston of said cylinderis pushed down to its fullest extent,'and the tubing inserted into themass of the material to be the outlet aperture I l,

loaded. By withdrawing the piston its fullest extent, suificient of thematerial is sucked up to completely fill the cylinder, and the operationis repeated with the material to fill the other cylinder. The tubing 56is then replaced to connect the tube with the cylinders. For maximumfilling, the tube 55, with the mixing chamber removed, is placed in thematerial and after the pistons are pushed down to expel the air from thepassages of the Y-tube 55, the pistons are drawn up separately until thecylinders and their respective communicating passages are completelyfilled with the substances desired. If such is to be used, the thirdingredient I8 is placed within the mixing chamber 12 and the latterplaced on the tube 55 in the desired position for proper mixing. Theyoke 46 is attached to the rods 30 and 3| between the collars 43 and M.The syringe is then inserted into the vagina and the injection effectedby manually pressing down on the yoke 46 to cause the pistons 34 toadvance until they reach the first calibration 4| whereupon the properdose will have been injected. The syringe may then be withdrawn andrinsed or sterilized externally and sealed by application of the cap 19,after which it is folded to the position shown in Fig. 3 and storedaway.

The construction shown is particularly designed for the simultaneousapplication of equal amounts of any portion of liquids or colloidsplaced in the reservoir cylinders, which, upon contacting each with theother produce a gas, thereby increasing the volume of the originalsubstances and aiding medicaments which may be incorporated therein tobe driven or carried into small crevices or remote tissue areas by thepressure of the gas, to an extent which has not hitherto been possiblewith liquids. Not only does the gas formed constitute a vehicle or pumpfor the medicaments of the original substances, but in many instances itgreatly increases the antiseptic or germicidal eiiectiveness of bothsolutions. For example, cylinder 22 could contain any well known acidlike tartaric acid, and cylinder 23 an alkali like sodium carbonate. Thetwo solutions or colloids containing these substances react uponcontacting with each other and generate gas, and the resulting foamymaterial would be extruded through the outlet hole of the mixingchamber. Another example would be a solution of sodium perborate in onecylinder and citric acid in the other. The resulting combination, whenbrought together would produce hydrogen peroxide. It is to be understoodthat more complex compounds may be used in this manner, such that uponcontact would generate chlorine and other known useful nascent gases. Inother words, the double syringe disclosed is not intended solely for themixing of two solutions which might contain substances to produce carbondioxide or hydrogen peroxide, but for any solutions which whencontacting each other will generate an appropriate gas.

Although the preferred embodiment of the invention described abovediscloses the use of two reservoir cylinders or storage chambers for themedicaments, it will be apparent that the apparatus may be constructedwith more than two cylinders, as for instance, where it is desired thatmore than two medicaments be simultaneously expelled from the syringe,without departing from the spirit of the invention. In such a case, itwill be understood that the syringe will preferably be equipped with anadaptor or delivery tube which may have more than two separate passages,or a number to correspond with the number of different medicaments orstorage chambers being used.

Having described my invention in detail above, it is to be understoodthat I am not to be limited to the embodiments herein shown anddescribed, but only by the scope of the appended claims.

What is claimed is:

1. The method of handling substances for medicinal treatment whichconsists in confining separately different liquids the natures of whichare such as to cause them upon contact to chemically combine to form agas, confining a still difierent material the nature of which is such asto cause it to chemically combine with the first-mentioned liquids, thesaid material being confined at a point predetermined and removed fromthe first-mentioned liquids, advancing the liquids while still confinedin spaced planes along substantially parallel paths, bringing theliquids together adjacent to the predetermined point while stilladvancing them to permit mixing, permitting the liquids to mix with thematerial at the predetermined oint and freeing the substances duringmixing and while still advancing to permit release of the gas.

2. In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially in parallel for containing reactablesubstances adapted to be mixed to produce a predetermined effect, amixing chamber communicating with the reservoirs, and means for varyingthe capacity of the mixing chamber for controlling the mixing of thematerials.

3. In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially in parallel for containing reactablesubstances adapted to be mixed to produce a predetermined eifect, aconduit communicating with both reservoirs, a mixing chambercommunicating with the conduit, and means for varying the capacity ofthe mixing chamber for controlling the mixing of the materials.

4. In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially in parallel for containing reactablesubstances adapted to be mixed to produce a predetermined efiect, aconduit communicating with both reservoirs at one end, and having anoutlet at the other end, a mixing chamber communicating with the conduitadjacent the outlet end, means for varying the capacity of the mixingchamber for controlling the mixing of the materials, and means formoving the materials from the reservoirs and through the conduit and themixing chamber.

5. In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially in parallel for containing reactablesubstances adapted to be mixed to produce a predetermined effect, aconduit one end of which communicates with both reservoirs, a mixingchamber communicating with the other end of the conduit, means forvarying the capacity of the mixing chamber for controlling the mixing ofthe materials, and means for simultaneously moving equal quantities ofthe materials from the reservoirs and through the conduit and the mixingchamber.

6. In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially in parallel for containing reactablesubstances adapted to be mixed to produce a predetermined effect, atubular mixing chamber communicating with the reservoirs and having acentral outlet, and means for varying the capacity of the mixing chamberfor controlling the mixing of the materials prior to their extrusion 8.In a syringe for compounding medicinal substances, a plurality ofreservoirs arranged substantially parallel for containing reactablesubstances adapted to be mixed to produce a predetermined efiect, aconduit communicating with both reservoirs at one end and having anoutlet adjacent the other end, an elastic mixing chamber communicatingwith the conduit adjacent the outlet end, and means for moving thematerials from the reservoirs and through the conduit and 10 mixingchamber.

HAROLD G. JOHNSON.

